Comparison of fibrin glue with staples on split thickness skin grafts surgery in burn patients: a randomized controlled trial

Background and Aim : Introduction: Historically, split-thickness skin grafts (STSG) have been fixed onto the recipient site by suture and/or staples. Fibrin sealants have become available for the fixation about 10 years ago. It consists of a combination of clotting factors and thrombin which have key roles in clot adherence and hemostasis. Fibrin sealants can reduce pain in comparison with staples. However, this product is much more expensive than traditional suture and/or staple fixation. This clinical trial aimed to assess clinical outcome and better healing of fibrin sealant for STSG fixation in burned wounds. Methods : Method: This randomized controlled trial was performed on 60 burned patients in Burn Center of Imam Reza Hospital. Patients were randomly assigned to undergo excision and grafting using staplers or fibrin sealant. Baseline characteristics, depth of burn, TBSA, area of grafting, graft and donor locations, rate of graft loss, rate of complete closure at 1 month, and time to discharge after surgery were recorded for each patient. Results : Results: Baseline characteristics were not different between the two groups. In the third day of assessment, use of fibrin glue has resulted in statistically significant lower rates of hematoma (41% vs. 73%, p=0.01), seroma (53% vs 80%, p=0.02), and infection (23% vs. 23%, p=0.03) in intervention group compared to control group. Additionally, more patients in intervention group had lower pain score (2-3) in comparison with controls (50% vs. 23%, p=0.02). The pigmentation, and itchy in two groups were not different. Conclusion : Conclusion: It seems that fibrin sealant can reduce hematoma, seroma and infection.

Keywords:

split-thickness skin graft , Fibrin sealant , skin stapler